{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:38:32Z","timestamp":1754163512363,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of intravascular hemolysis caused by a somatic mutation in the gene responsible for glycosylphosphatidylinositol (GPI)-anchored complement regulatory proteins. This mutation leads to the production of abnormal blood cell clones lacking CD55 and CD59. PNH can result in renal damage. The challenge of early identification and diagnosis leads to misdiagnosis as other intravascular hemolytic conditions. This paper presents a case that began with fever, diarrhea, and acute renal failure, initially misdiagnosed as atypical hemolytic uremic syndrome (aHUS) but later confirmed as PNH through renal biopsy and related diagnostic tests. After treatment, the patient\u2019s renal function recovered, and anemia improved. Intravascular hemolysis is a prominent feature common to both PNH and HUS. They exhibit similar clinical manifestations, which pose a challenge for differential diagnosis. Unlike previous reports, the patient in this case denied any history of hematologic disorders, which made the diagnosis more challenging.<\/jats:p>","DOI":"10.3389\/fmed.2025.1553168","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:37:58Z","timestamp":1753940278000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Paroxysmal nocturnal hemoglobinuria masquerading as hemolytic uremic syndrome: a Case Report"],"prefix":"10.3389","volume":"12","author":[{"given":"Menghan","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianping","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuhan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"17028","DOI":"10.1038\/nrdp.2017.28","article-title":"Paroxysmal nocturnal haemoglobinuria","volume":"3","author":"Hill","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1016\/S0140-6736(22)01202-8","article-title":"Haemolytic uraemic syndrome","volume":"400","author":"Michael","year":"2022","journal-title":"Lancet (London, England)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12104","DOI":"10.3390\/ijms252212104","article-title":"Thrombosis in paroxysmal nocturnal hemoglobinuria (PNH): from pathogenesis to treatment","volume":"25","author":"Kokoris","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref4","first-page":"1139","article-title":"Renal involvement in paroxysmal nocturnal haemoglobinuria: a brief review of the literature","volume-title":"Rev Assoc Med Bras","author":"Macedo","year":"1992"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e28448","DOI":"10.7759\/cureus.28448","article-title":"Classical paroxysmal nocturnal hemoglobinuria presenting with severe anemia and pigmented acute kidney injury","volume":"14","author":"N","year":"2022","journal-title":"Cureus"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"565","DOI":"10.14744\/SEMB.2021.03443","article-title":"MRI as a Aiagnostic tool for paroxysmal nocturnal hemoglobinuria: a case report","volume":"55","author":"Von Bodelschwingh","year":"2021","journal-title":"Sisli Etfal Hastanesi tip bulteni"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/S0140-6736(17)30062-4","article-title":"Haemolytic uraemic syndrome","volume":"390","author":"Fakhouri","year":"2017","journal-title":"Lancet (London, England)."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3699","DOI":"10.1182\/blood-2005-04-1717","article-title":"Diagnosis and management of paroxysmal nocturnal hemoglobinuria","volume":"106","author":"Parker","year":"2005","journal-title":"Blood"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/j.1600-0609.2009.01338.x","article-title":"Paroxysmal nocturnal haemoglobinuria: diagnostic tests, advantages, & limitations","volume":"83","author":"Madkaikar","year":"2009","journal-title":"Eur J Haematol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1111\/vox.13354","article-title":"Whole blood transfusion and paroxysmal nocturnal haemoglobinuria meet again: minor incompatibility, major trouble","volume":"117","author":"Laegreid","year":"2022","journal-title":"Vox Sang"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E6","DOI":"10.1111\/hdi.12591","article-title":"Acute kidney injury in a postpartum woman with paroxysmal nocturnal hemoglobinuria: a case report and literature review","volume":"22","author":"Nishimoto","year":"2018","journal-title":"Hemodial Int"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1553168\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:37:59Z","timestamp":1753940279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1553168\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":11,"alternative-id":["10.3389\/fmed.2025.1553168"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1553168","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"article-number":"1553168"}}